The diagnosis of acute coronary syndrome (ACS) in a primary care setting is challenging; it is seldom seen, compared to other more benign conditions presenting with chest pain, and missing the diagnosis can be catastrophic for the patient. Prompt diagnosis facilitates access to early revascularisation which improves outcomes. This article will update general practitioners on the diagnosis and management of acute coronary syndromes and provides case-based examples with ECGs to improve diagnostic confidence.

Atrial fibrillation (AF) is the commonest arrhythmia associated with a significant cardiovascular disease burden, with increased risk of a number of comorbidities; of particular concern is the five-fold increased risk of stroke. The management of the condition consists of effective symptom control and adequate protection from associated adverse events. A combination of different therapeutic agents can be used to achieve these goals, tailored to the needs of the individual. The cardiologist’s input may only be relatively small, concerned with managing acute presentations and performing certain procedural interventions. The role of the primary care physician is arguably more significant, delivering a holistic package of care that considers the broad needs of a person with AF.